Anne Huebner & Associates
Phone: 262-786-9184 262-786-4665
17100 W. North Ave., Ste. 100 Brookfield, 53005
Fax: 262-786-1906
PSYCHOLOGICAL POLICIES AND SERVICES
What you can expect from us ~ What we can expect from you
Welcome!
On the following pages you will find a summary of important details about our professional services and
business policies. Our purpose here is to fully inform you about your rights and privileges as a consumer of
psychological services. Please read it carefully and note any questions for discussion.
Psychological Services
Psychotherapy and counseling are often used in the same way. However, psychotherapy focuses on resolving
serious difficulties in emotional, cognitive, behavioral, and/or relationship areas, while counseling facilitates
personal growth and problem-solving about life issues. Both types of psychological services are used at this
clinic, but “psychotherapy” will be used for simplicity in this document. In psychotherapy then, different
approaches can be used depending on a) personalities of therapist and client and b) problems or disorders to
be addressed. Different from visiting a medical doctor, though, your active effort is required during sessions
and at home for this work to be successful.
Psychotherapy has both benefits and risks. Benefits have been supported by research, and they include
reduction in distressing symptoms, better relationships, and resolving specific problems. These benefits are not
guaranteed but tend to be related to factors noted above. Risks sometimes include experiencing uncomfortable
feelings like sadness, guilt, anxiety, anger, frustration, and, recalling unpleasant personal history.
Since you are entitled to know your diagnosis and collaborate with us on treatment goals, we will be able to
offer initial impressions by the end of our evaluation phase. We will then discuss our recommendations and
work together on an initial treatment plan. Though we will discuss therapy strategies that can benefit you, it is
also important that you ask questions about your therapy as they arise.
You can always choose to terminate psychotherapy with your therapist at any time. However, you and your
therapist may also come to an agreement that your therapy should end or that it should be continued with
someone else. In any case, we would be happy to provide an appropriate referral to another mental health
professional. Your file will then be kept confidential for the legally recommended time period after which it will
be destroyed.
Sessions
Our normal practice is to conduct an initial evaluation during one or two 50-60 minute sessions. During this
time, we can both decide whether one of us is the best person to provide the services you need to meet your
treatment goals. If we proceed with follow-up sessions, we will usually schedule one session every 1-2 weeks
unless more frequent sessions are necessary. Once this appointment is scheduled, you will be expected to pay
for it unless you provide at least 24 hours advance notice of cancellation or rescheduling. A cancellation fee of
$100 is charged without 24-hour advance notice, a fee that insurance companies do not cover.
Professional Fees
Our hourly fee of $250.00 is considered “usual and customary charges” for an individual session in our area.
Initial evaluations and shorter or longer sessions are pro-rated based on that hourly fee. Other professional
services such as report writing, phone conversations lasting 5 minutes or longer, attending meetings or
consultations with other professionals you have authorized, preparing treatment summaries, or additional
services you may request will also be charged at the $250.00/hour prorated basis.
If you prefer to pay for psychotherapy sessions on a cash basis, the regular fee is reduced to $150 per hour.
If your situation involves litigation requiring our participation, different fees will be charged because of the
complexity and difficulty of legal involvement. These charges will also be your responsibility even if we are
compelled to testify by another party. Other information about legal services and fees can also be discussed if
they or when they arise.
Billing and Payments
Billing services are provided by staff member Vicki, a trained billing specialist with more than 30 years of
experience. If you have questions about your bill, please call the office at 262-786-9184.
Payment for copays is expected at each session though you may choose to be billed monthly. Prompt payment
then is expected each month. However, if your account is more than 45 days overdue and suitable
arrangements for payment have not been agreed to or followed; legal methods will be used to secure payment
(collection agencies or small claims court). If such legal action is necessary, the costs of bringing that action to
court will be included in the claim as allowed by law. In those cases, the information released about treatment
would include name, address, dates of services, and amount due.
Insurance Reimbursement
Being fully informed about your insurance, evaluating it and other financial resources to pay for your services is
critical in preventing disrupted care. If you have health insurance, it will usually provide some coverage for
mental health treatment, and that coverage may affect realistic treatment goals. Our administrative manager
will assist in verifying your benefits, and several forms may need to be completed. However, you, not your
insurance company, are responsible for full payment of the fee to which we have agreed regardless of the
status of your claim or your insurance company’s arbitrary determination of usual and customary rates. For
example, in the event of insurance denials, rejections, errors, or non-covered services, your responsibility in
paying for all services remains. Because of this, it is critical to know exactly what mental health services your
insurance policy covers. Please carefully read the benefit section in your insurance booklet for mental health
services and call to verify specific benefits.
After all your insurance coverage information has been obtained, we will discuss what we can expect to
accomplish with those benefits. We will also discuss what will happen if the insurance benefits run out before
you feel ready to end our sessions. It is important to remember that you always have the right to pay cash for
services yourself and avoid the complexities described above. As noted earlier, a reduced hourly fee of $150 is
charged for services provided on a cash basis.
As your psychotherapy proceeds, coverage for mental health care services can become difficult despite
gathering specific information when services begin. Managed health care plans such as HMOs and PPOs
often require advance authorization before they will provide reimbursement for mental health services. These
plans are often oriented toward short-term therapy, which is designed only to resolve problems interfering with
one’s usual functioning. Though short-term therapy can be helpful, many people feel that more services are
necessary. Additionally, these plans overlook the fact that many mental health disorders can require additional
services. Overall then, it may be necessary to seek additional approval after a certain number of sessions. If
benefits run out, other options or resources for your well-being can be discussed again.
Finally, please be aware that most insurance policies require you to authorize us to provide a clinical diagnosis
and sometimes a treatment plan, summary, or a copy of your entire record. This information will become part
of the insurance company files and will likely be computerized. All insurance companies claim to keep such
information confidential, but in some cases they may share the information with a national medical information
data bank.
Contacting Us
When you call, you may find that we are often unavailable since we are either in sessions, completing office
work, or teaching. At these times our administrative manager or voicemail will take your call, and we will
answer within 24 hours on weekdays unless an emergency has occurred. If you believe that you cannot wait
for us to return your call, you should call your family physician or visit the emergency room at the nearest
hospital asking for the on-call psychologist or psychiatrist. If we are unavailable for an extended time, such as
a holiday, we will provide you with the name of a colleague whom you could contact if needed.
Professional Records
Both the law and standards of the psychology profession require that we keep treatment records for 7 years.
You are entitled to receive a copy of your records if you wish, and you are entitled to see your records.
However, professional wording can be confusing, misinterpreted, and/or distressing. As a result we often prefer
to prepare an appropriate summary of records, forward them to an appropriate mental health professional for
further discussion, or review them together to discuss what they contain.
Please know that fees for any preparation time or copying costs for a records request will be charged as usual.
Minors
If you are under 18 years old, please be aware that the law provides your parents with the right to examine
your treatment records if they insist. If your parents agree, we will provide them only with general information
on how your treatment is proceeding unless we believe there is a high risk that you will seriously harm yourself
or another. In these cases, we will discuss our intention to talk with your parents, but we must notify your
parents by law. However, it is most important to know that before giving them any information, we will discuss
the matter with you to resolve any concerns you may have.
Confidentiality
In general, the law protects the confidentiality of all communications between a client and a psychologist. As a
result, we can only release information about our work to others with your written permission. There are a few
exceptions to this since we are legally required to take action to protect others from harm. Because of this, we
may be required to reveal some information about a client’s treatment. Exceptions include: a) if we believe that
a child, an elderly person, or a disabled person is being abused, we must file a report with the appropriate state
agency; b) if we believe that a client is threatening serious bodily harm to another, we are required to take
protective actions, which may include notifying the potential victim, notifying the police, or seeking appropriate
hospitalization; and c) if a client threatens to harm him/herself, we are required to seek hospitalization for the
client or to contact family members or others who can provide protection. Should such a situation occur, we
would make every effort to discuss this with you before taking any action.
Your confidentiality is also affected in some judicial proceedings. For example, you may have the right to
prevent us from providing any information about your treatment in some legal situations. In other legal
situations, such as disability evaluations, or proceedings in which your emotional condition is an important legal
issue, your rights to confidentiality are quite limited. We will discuss this as situations arise, but your questions
about confidentiality in legal situations are always appreciated.
Finally, it is often helpful to consult with other professionals who provide medical or psychological care to you.
In these cases, your signature on a release of information will allow us to discuss your situation with these
professionals from a legal standpoint. In other cases, consulting with colleagues can provide helpful
perspectives. When this occurs, identifying information is never revealed, and the consultant is also legally
bound to maintain confidentiality. Our policy is to discuss such consultations with you if they are necessary.
Given the summary confidentiality above, any questions or concerns that you may have are still important to
discuss. Since the laws about these issues are quite complex, we would be happy to explain confidentiality
issues or provide other resources for you.
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Thank you for taking the time to read this lengthy summary. Our goal was two-fold: to provide thorough
information about expectations and business policies involved in psychotherapy services; and to provide the
same thorough information about your rights and privileges regarding psychotherapy services. Please know
that we are always open to discuss your questions and concerns about these matters.
After reading this material and discussing any concerns you may have, you will be asked to sign several forms
that are based on the information above. These include an Informed Consent and a HIPPA policy. Your
signature on these forms verifies your understanding of and agreement to the practices and policies of
psychotherapy, and we look forward to working with you.
Sincerely,
Anne Huebner, Ph.D.
Licensed Psychologist
Anne Huebner & Associates, LLC